Diabetes causes several skin changes after its onset — but did you know your skin can reveal signs of the disease much before your blood sugar rises?
If you have been living in this region for some time, there is a high probability that either you or someone you know has been diagnosed with diabetes. The Gulf countries are at top of the list of countries with high diabetes prevalence. India, the country that contributes maximum expatriates to the region, is called the diabetic capital of the world with over 40 million diabetics. Much has been discussed about this growing menace and its possible causes and solutions. But did you know that your skin could give signs of this impending ‘epidemic’ much before your blood sugar rises? In fact, your skin could also give indications as to the level of diabetic control and the evolving complications.
It is widely accepted now that being overweight is a high risk factor for Type 2 diabetes. Many overweight people may have a blackish discoloration around the back of their neck. It can also extend to the underarms. This condition is often caused by rising levels of insulin in blood and could well be a harbinger of diabetes — though it can occur in healthy individuals too. So if you have this problem, it is time to start using your jogging outfit and cut back on that midday snack. This type of pigmentation does not generally improve much with whitening creams or cosmetic procedures.
How do you know whether you have crossed the line and become a diabetic? The skin of diabetics generally becomes thicker compared to non-diabetics. This is due to cross-linking of skin fibres or collagen. Skin and nails develop a yellow hue. Increased viscosity of the blood leads to redness of the face. You may develop itching without any apparent cause. You may also develop blisters or yellowish bumps under the skin on the hands or legs.
Uncontrolled diabetes can lead to several skin changes as well. Diabetes reduces your ability to fight disease, causing germs. Hence uncontrolled diabetes can lead to certain infections that can threaten life and, more often, limb! The commonest infection in diabetics of this region is yeast infection of the web spaces of the toes called intertrigo. This infection produces a soft, macerated, whitish patch (commonly between the fourth and fifth toes). It is important to keep your feet dry. Diabetics should periodically check their feet for signs of infection. Boils, infection of the nails and other fungal infections are also common in them.
If diabetes remains uncontrolled for a prolonged period, it can affect your nerves and blood vessels. Destruction of nerves reduces your pain sensation and the ability to avoid injury. Minor injuries accumulate leading to ulceration at the toe tips. These ulcers take a long time to heal. Infections can spread through these ulcers leading to further complications. Most diabetics complain of tingling and numbness too. Hence, it is important for them to use footwear that covers and protects the feet.
Have you noticed light brown, oval, scaly patches on the shins of your elderly diabetic relatives? Though the exact cause is not known, these patches are supposed to be due to damage to blood vessels and altered micro-circulation. Though there is no treatment for these patches, they may sometimes improve following good diabetic control. Although these patches are harmless, they could be forerunners of more sinister complications like eye and kidney damage.
Several medications are used for the treatment of diabetes. These drugs can produce allergies in some causing reddish rashes, mainly on the hands and feet. It may take two weeks or more for the rash to develop after starting the drug. It is important to promptly report any such allergies to your physician, so that he can change the incriminated drug.
Diabetes reduces the healing capability of your body. Most of the cosmetic procedures can produce minor skin injuries. It is important to bring your blood sugar under control before doing any aggressive cosmetic procedures. Always inform your doctor about your diabetic status before doing any cosmetic procedure.
The increased diabetic prevalence in the region is due to lack of physical activity and other lifestyle choices. Keeping your diabetes under control is the most important factor in preventing skin-related complications.
Follow your doctor’s advice regarding nutrition, exercise and medication. Keep your blood glucose level within the range recommended by your doctor. Proper skin care can also help reduce your risk of skin problems.
Diabetes is a common ailment especially in this region and virtually everyone with diabetes will develop some skin change or the other. Careful observation of these skin changes would help the patients and physicians alike to have an idea about the present and past diabetic status.
(Dr Bell R Eapen is a Dubai-based specialist dermatologist with Kaya Skin Clinic. Write to him at firstname.lastname@example.org)